Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 1072072 | KY |
NPI | 1083694996 |
---|---|
Provider Name | Amy L Watson Reese |
First Address | Louisville, KY 40201-0909 |
Second Address | Louisville, KY 40202-3818 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2006 |
Last Update Date | 02/10/2014 |